Nursing Care of Children: Asthma – Flashcards

Allergens • Airway irritants • Stress and strong emotions • Acute illness • Exercise • Cold air or changes in weather or temperature • Animal hair or dander • Medications: aspirin, NSAIDs, antibiotics, beta blockers

• Peak expiratory flow meter • Pulmonary function tests • Oxygen saturation • Arterial blood gas • Chest x-ray • Bronchoprovocation testing • Skin prick testing

• Obtain vital signs and oxygen saturation. • Assess airway patency • Assess breath sounds. • Assess work of breathing. • Monitor LOC. • Monitor I&O. • Administer bronchodilators. • Administer oxygen. • Administer IV steroids. • Administer antibiotics (oral, IV, IM). • Administer fluids (oral, IV). • Maintain a calm and reassuring demeanor

• Teach child, family appropriate use of medications, metered-dose inhaler. • Identify factors that trigger exacerbations. • Treatment plan based on peak expiratory flow rate. • Green zone: 80%-100% of expected peak flow rate • Usually symptom-free • Yellow zone: 50%-80% of expected peak flow rate • Indicates development of an asthma attack • Red zone: below 50% of expected peak flow rate • Experiencing acute exacerbation

• Teach client to perform around same time each day. 1. Slide marker or arrow to bottom of numbered scale. 2. Take deep breath. 3. Place lips tightly around mouthpiece. 4. Blow out hard and fast as possible, empting all air from lungs. 5. Note number on scale each time performed. 6. Repeat routine three times. 7. Record highest rating. 8. Keep chart of measurements.

albuterol, levabuterol, terbutaline used for acute exacerbations prevention of exercised-induced asthma

formoterol, salmeterol used to prevent exacerbations, especially at night, and reduce use of SABA must be used along with anti-inflammatory therapy CAN'T be used to treat acute exacerbations

atropine, ipratropium block the parasympathetic nervous system, providing relief of acute bronchospasms

decrease airway inflammation

parenterally (methylprednisolone), orally (prednisone), or by inhalation (fluticasone) oral systemic steroids can be given for short periods (3 or 10 days) inhaled corticosteroids are administered daily as a preventive measure

Leukotriene modifiers (montelukast) mast cell stabilizers (cromolyn)

omalizumad used to treat moderate to severe persistent allergic asthma uncontrolled by corticosteroids in children 12 years old and older

include a LABA and inhaled corticosteroid

• Teach the family and child how to recognize an asthma exacerbation (decreased PEFR, increased use of SABA, difficulty speaking or eating). ● Teach the family and the child about when to use each of the prescribed medications (rescue medications vs. maintenance medications). ● Educate the child and family regarding infection prevention techniques. ◯ Promote good nutrition. ◯ Reinforce importance of good hand hygiene. ◯ Reduce allergens in the child's environment ● Encourage prompt medical attention for infections. ● Stress the importance of keeping immunizations, including seasonal influenza and pneumonia vaccines, up to date. ● Encourage regular exercise as part of asthma therapy. ◯ Promotes ventilation and perfusion ◯ Maintains cardiac health ◯ Enhances skeletal muscle strength ● Children can require medication before exercise.